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[在中国西南部的儿科重症监护病房预测死亡率的不同方法]
1Department of Pediatric Critical Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, Chongqing 400014, China.
Zhonghua er ke za zhi = Chinese journal of pediatrics
|February 20, 2024
概括
儿科顺序性器官衰竭评估 (pSOFA) 和儿科危急疾病评分 (PCIS) 是比系统性炎症反应综合征 (SIRS) 更好地预测儿科败血症死亡率. 这些发现可以改善儿科重症监护病房患者的治疗结果.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 传染性疾病 传染性疾病
- 临床评分系统 临床评分系统
背景情况:
- 儿科败血症是一种危及生命的疾病,需要准确的预后工具.
- 像SIRS这样的现有评分系统在预测死亡率方面可能存在局限性.
- 需要在不同的人群中评估各种评分系统的有效性.
研究的目的:
- 为了比较系统性炎症反应综合征 (SIRS),儿科序列器官衰竭评估 (pSOFA) 和儿科关键疾病评分 (PCIS) 对儿科败血症死亡率的预测值.
- 在中国西南地区的儿科重症监护室 (PICU) 住院的儿童中评估这些分数.
主要方法:
- 一项前性多中心观察性研究,涉及447名儿科败血症患者.
- 数据收集包括SIRS,pSOFA和PCIS分数在PICU入院后24小时内.
- 用接收器运行特征 (ROC) 曲线分析来确定用于死亡率预测的曲线下的面积 (AUC).
主要成果:
- 与SIRS (AUC=0.56) 相比,pSOFA (AUC=0.82) 和PCIS (AUC=0.78) 对败血症死亡率的预测值明显更高.
- 非生存组比生存组显示出明显更高的pSOFA得分和较低的PCIS得分.
- 一些实验室标记物,包括乳酸盐和前素,也显示出预测价值.
结论:
- 在PICU中,pSOFA和PCIS在预测儿科败血症患者的死亡率方面优于SIRS.
- 这些经过验证的评分系统可以帮助早期风险分层和儿童败血症的管理.
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